Individual
MR. JASON R SPRUILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OCCUPATIONAL THERAP
Contact information
Practice address
101 MEDICAL DRIVE, ELIZABETH CITY, NC 27909
(252) 338-2114
(252) 338-2115
Mailing address
101 MEDICAL DRIVE, ELIZABETH CITY, NC 27909
(252) 338-2114
(252) 338-2115
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4576
NC
225XH1200X
Hand Occupational Therapist
4576
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417N
BCBS
NC
05
—
7301483
—
NC
Enumeration date
01/04/2007
Last updated
06/25/2008
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